Review Article

Advantages and Challenges of Virtual Outpatient Education: A Review Article

Abstract

This study reviews articles published in the last two decades to determine the pros and cons of virtual outpatient education for undergraduate medical students and residents. A review of articles published between 2001 and 2021 in PubMed, Scopus, ERIC, and google scholar databases. Keywords for this search were: Ambulatory care/Outpatient clinics and education, and medical/internship and residency. The emphasis of this study was on the implementation of any kind of E-learning in outpatient clinics. Out of 5100 in the initial monitoring, 168 articles were reviewed based on the full text. Finally, information on 11 articles was extracted. Results were summarized in 4 areas: methods and tools used in e-learning, benefits of e-learning, challenges and limitations of e-learning, and student support. The main methods used were telemedicine via video conferencing and telephone calls, especially for residents. Other were virtual clinics with a simulated patient, as well as online educational modules. The main preponderances were: increasing knowledge and skills of telemedicine, improving medical knowledge and skills, access to educational resources even during patients visit, the possibility of learning at any time and place, and betterment of the quality of care. The main challenges were lack of technological literacy and lack of Internet access for some patients, time-consuming entry of patient information for students, reduction of clinical experiences, the unfeasibility of acquiring full skills in performing physical examinations, or some technical and procedural skills and hardware/software technological problems. Regarding student support, the main activity includes holding orientation sessions on new approaches for trainees. Due to the urgency of using virtual outpatient education in the corona era, it is predicted that in the post-corona era, we will see a tendency to use this method by stakeholders. Certainly, citing the results of original articles and reviewing them, similar to the present study, can make it possible to implement qualified E-learning innovation in clinics with quality in the future.

1. Zale AD, Song CI, Zhou A, Lai J, Jang M, Lipsett PA, et al. A Qualitative Study of the Barriers and Benefits to Resident Education in Ambulatory Surgical Centers. J Surg Educ 2021;78:1825-37.
2. Coyle A, Helenius I, Cruz CM, Lyons EA, May N, Andrilli J, et al. A Decade of Teaching and Learning in Internal Medicine Ambulatory Education: A Scoping Review. J Grad Med Educ 2019;11:132-42.
3. Dent JA. AMEE Guide No 26: clinical teaching in ambulatory care settings: making the most of learning opportunities with outpatients. Med Teach 2005;27:302-15.
4. He X, Shelden D, Kraftson A, Else T, Auchus RJ. A virtual teaching clinic for virtual care during the COVID-19 pandemic. Clin Diabetes Endocrinol 2020;6:25.
5. Goh PS, Sandars J. A vision of the use of technology in medical education after the COVID-19 pandemic. MedEdPublish 2020:1-8.
6. Weber AM, Dua A, Chang K, Jupalli H, Rizwan F, Chouthai A, et al. An outpatient telehealth elective for displaced clinical learners during the COVID-19 pandemic. BMC Med Educ 2021;21:174.
7. Rydel TA, Bajra R, Schillinger E. Hands Off Yet All In: A Virtual Clerkship Pilot in the Ambulatory Setting During the COVID-19 Pandemic. Acad Med 2021;96:1702-5.
8. Gachanja F, Mwangi N, Gicheru W. E-learning in medical education during COVID-19 pandemic: experiences of a research course at Kenya Medical Training College. BMC Med Educ 2021;21:612.
9. Chiu CY, Sarwal A, Jawed M, Chemarthi VS, Shabarek N. Telemedicine experience of NYC Internal Medicine residents during COVID-19 pandemic. PloS One 2021;16:e0246762.
10. Chao TN, Frost AS, Brody RM, Byrnes YM, Cannady SB, Luu NN, et al. Creation of an Interactive Virtual Surgical Rotation for Undergraduate Medical Education During the COVID-19 Pandemic. J Surg Educ 2021;78:346-50.
11. Rasalam R, Bandaranaike S. Virtual WIL Clinics in Medicine: Overcoming the COVID-19 Challenge. J Work-Integrated Learn 2020;21:573-85.
12. Frehywot S, Vovides Y, Talib Z, Mikhail N, Ross H, Wohltjen H, et al. E-learning in medical education in resource constrained low- and middle-income countries. Hum Resour Health 2013;11:4.
13. Shehata MH, Abouzeid E, Wasfy NF, Abdelaziz A, Wells RL, Ahmed SA. Medical Education Adaptations Post COVID-19: An Egyptian Reflection. J Med Educ Curric Dev 2020;7:2382120520951819.
14. Afshari M, Witek NP, Galifianakis NB. Education Research: An experiential outpatient teleneurology curriculum for residents. Neurology 2019;93:170-5.
15. Succar T, Zebington G, Billson F, Byth K, Barrie S, McCluskey P, et al. The impact of the Virtual Ophthalmology Clinic on medical students’ learning: a randomised controlled trial. Eye 2013;27:1151-7.
16. Wünschel M, Leichtle U, Wülker N, Kluba T. Using a web-based orthopaedic clinic in the curricular teaching of a German university hospital: analysis of learning effect, student usage and reception. Int J Med Inform 2010;79:716-21.
17. Szeftel R, Hakak R, Meyer S, Naqvi S, Sulman-Smith H, Delrahim K, et al. Training Psychiatric Residents and Fellows in a Telepsychiatry Clinic: A Supervision Model. Acad Psychiatry 2008;32:393-9.
18. Dy SM, Hughes M, Weiss C, Sisson S. Evaluation of a web-based palliative care pain management module for housestaff. J Pain Symptom Manage 2008;36:596-603.
19. Sisson SD, Hughes MT, Levine D, Brancati FL. Effect of an Internet-based curriculum on postgraduate education. A multicenter intervention. J Gen Intern Med 2004;19:505-9.
20. Speedie S, Pacala J, Vercellotti G, Harris I, Zhou X. PDA support for outpatient clinical clerkships: mobile computing for medical education. Proc AMIA Symp 2001;632-6.
Files
IssueVol 60 No 8 (2022) QRcode
SectionReview Article(s)
DOI https://doi.org/10.18502/acta.v60i8.10829
Keywords
Ambulatory care Outpatient clinics Medical education Internship and residency E-learning Virtual education

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How to Cite
1.
Barzegar M, Boushehrii E, Amini M, Tabari P. Advantages and Challenges of Virtual Outpatient Education: A Review Article. Acta Med Iran. 2022;60(8):457-464.